Trust Me, I'm A junior Doctor

This book is written by Max Pemberton, when he was a junior doctor (or aka houseman/ house officer/ intern). He is now a psychiatrist-in training and also a columnist with the Daily Telegraph.

Well, this book answered my question- the crazy hellish life of a junior doctor, is it just in Malaysia or is it a global phenomenon? Reading Max was like reading my own diary (which I never wrote). Although now the condition here must have got better since the implementation of European Working Time Directive where working hours and on call requirements have been reduced.

Max described it well. It is a life of either you are working, or you are recovering from working, so that you are able to work the next day (but come to think of it, what work doesn't?).

And the constant feeling of 'I should leave medicine forever' or 'I want to quit now' every time you were scolded by your consultant (in front of the whole team) or a patient you cared for died or when you received abusive words from the patient's families (quite commonly the 'goverment sector' sentiment will be brought up).

But frankly, I never had the thought of quitting or leaving medicine forever, but I did have the occasional feelings of 'I just want to go home now' or 'can I faint now?'. Actually it was quite reasonable for me to faint because I was pregnant with Adam that time. Tapi korang tau lah, aku bukan drama queen kan..

And this is my favourite part of the book, on how we medical personnel detach ourselves from feelings, because to us everything has an explanation.....

Mr Farley has had dementia for the past ten years. His wife has looked after him for all that time, day in, day out. And now his kidneys and heart have stopped working properly. Medicine has decided to bow out gracefully and admit defeat. There's nothing that can be done. He and his wife are in their eighties. How she's coped on her own all this time is beyond me. His eyes are shut and his mouth wide open.

"It's all right darling, I'm here" says Mrs Farley.

No response. She looks a little crestfallen. She gently strokes his cheek while talking to him, and he moves his head towards her.

"Look, Doctor, he still knows who I am," she says to the doctors lined up at the foot of the bed.

But everyone looked slightly embarrassed and Dr Pike says gently, "We're very sorry, there's nothing more we can do. I think it's for the best."

Everyone quietly moves on.

Back in the office I accost Barney, my senior. "But he recognizes his wife, that's incredible, isn't it?" I say.

Barney frowns. "Oh that, no, of course he doesn't recognize her."

I'm perplexed.

"It's rooting reflex," Barney explains. "He's got advanced dementia. He hasn't a clue what's going on."

What this means is that the movement Mrs Farley thinks is her husband recognizing her voice is, in fact, a mere reflex. Anyone or anything touching his cheek would induce the same response.

I feel somehow cheated. I think I prefer Mrs Farley's explanation. Medicine can be cruel like this. It reduces things to neural pathways, to reflexes, to physiological mechanisms. It removes the mystery and wonder from things. Mrs Farley doesn't want to live in a world where her husband has primitive rooting reflex. She wants to live in a world where her husband recognizes her voice.

---------------------------------------------------------------------------------------------------

And look what my mother bought me as souvenir from Amsterdam...